Case in Point: Meet Alexis

Alexis is a 14 year old girl from New York.  She was referred to you by her pediatrician after a positive Chlamydia test and concerns about cutting school and problems in the home.  The doctor also mentions an issue with sexual abuse previously reported to the authorities.  

Two months ago, Alexis left New York to live with her father, after revealing that she had been raped by the mother's boyfriend when she was 12.  Alexis's mother chose not to believe her, leading Alexis to move to Philadelphia with her father and step-mother, who previously lived alone.  During the interview, Alexis tells you she is not sexually active and has no boyfriend.  She explains that when she was absent from class 50 times she was in the counselor's office working on anger management.  She mentions tension between herself and the step-mother, saying that the step-mother doesn't respect her and she feels that it may come to blows between the two of them.

When describing the situation, Alexis is sweet and engaging, she laughs when appropriate and listens intently as questions are asked.  She cries when the subject of her abuse arises and becomes very angry when her mother's reaction is mentioned.  In the end, she says that she thinks counseling would be helpful for her to move forward and that she is willing to work with her new family.
                 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"I can't believe she chose him over me.  She's supposed to be my mother."

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Alexis was brought to the office by her step-mother, who describes a completely different scenario.  From what she says, Alexis has been sending and receiving sexually explicit text messages, sneaking out of the house at night and bringing boys home during the day when she cuts class.  They took her cell phone as punishment only to find another one that her boyfriend gave her; and when they confronted her, the argument almost turned into a fight. Alexis' father desperately wants to get his daughter some help, but her behavior has turned the house into a "war zone."

Where do we start with this family?  What should we do FIRST with Alexis?